Postpartum dönemde COVİD-19 fobisinin yalnızlık ve depresyon üzerine etkisinin incelenmesi
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Tarih
2023
Yazarlar
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Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Yeni doğum yapmış hayatının çok önemli ve zorlu bir döneminden geçen, salgın gibi olağan dışı durumlar olmadığı zaman bile depresyon riskinin arttığı postpartum kadınlarda COVID-19 pandemisinin yol açtığı korku duygusunun ve doğumda, doğum sonrasında hastalığın bulaşma riskinden dolayı hiçbir yakınından yeterince destek görememesinin sebep olduğu yalnızlık duygusunun depresif duygu durumunu daha da arttırabileceği ve bu dönemi daha zorlu geçirmelerine sebep olabileceği düşünülmektedir. Bu çalışmanın amacı da birinci basamağa başvuran 4-8 haftalık bebeği olan postpartum dönemdeki kadınlarda COVID-19 fobisinin, depresyon ve yalnızlık üzerine etkisinin araştırılmasıdır.
Gereç ve yöntem: Bu çalışma Konya ilinin üç merkez ilçesinden (Meram, Selçuklu, Karatay) seçilen toplam 6 Aile Sağlığı Merkezine 01.06.2021-01.09.2021 tarihleri arasında başvuran doğumunun üzerinden 4-8 hafta geçmiş kadınlar dahil edilerek gerçekleştirildi. Katılımcıların sosyodemografik özelliklerini ve bebeğiyle alakalı özelliklerini değerlendirmeye yönelik sosyodemografik bilgi formu, postpartum depresyon durumunu değerlendirmeye yönelik “Edinburgh Postpartum Depresyon Ölçeği”, COVID-19 fobisini değerlendirmeye yönelik “COVID-19 Fobi Ölçeği”, yalnızlık düzeylerini değerlendirmek için ise “UCLA Yalnızlık Ölçeği” uygulandı. İstatiksel analizler için SPSS 20.0 (Statistical Package for Social Sciences) programı kullanıldı. İstatiksel anlamlılık düzeyi p<0,05 kabul edildi.
Bulgular: Çalışmaya katılan 425 kişinin yaş ortalaması 28,57±4,59 (min=18; maks=42) yıl olarak hesaplandı. Katılımcıların %56,4’ü (n=240) üniversite mezunuydu, %48,5’i (n=206) doğum öncesinde çalışıyordu. Katılımcıların %21,9’unun (n=93) geliri giderinden çok, %55,3’ünün (n=235) geliri giderine eşit, %22,8’inin geliri giderinden azdı, %95,1’i il
ix
merkezinde yaşıyordu. Katılımcıların %88,2’sinin son gebeliği istenilen bir gebelikti ve %22’si bebek bakımı konusunda hiçbir yardım almıyordu. Katılımcıların %22,3’ünde (n=95) postpartum depresyon belirtisinin olduğu bulundu, EPDÖ puanlarıyla öğrenim durumu (p<0,001) ve doğum öncesi çalışma durumu (p<0,001) arasında anlamlı ilişki saptandı, öğrenim durumu lise ve altı olanların ve doğum öncesinde çalışmayanların ortalamaları daha yüksekti. Algılanan gelir düzeyi ile EPDÖ toplam puanı arasında istatiksel olarak anlamlı bir ilişki saptandı (p<0,001). Geliri giderinden az olan katılımcıların PPD sıklığı geliri giderine eşit ve geliri giderinden çok olanlardan daha yüksekti. Plansız gebe kalan (p=0,004) ve doğum öncesi COVID-19 geçiren annelerde (p=0,001) PPD sıklığı daha fazlaydı. Katılımcıların çocuk sayısı (p=0,001), öğrenim durumu (p<0,001) ve doğum öncesi çalışma durumu (p=0,004) ile yalnızlık düzeyi arasında istatiksel olarak anlamlı ilişki bulundu. Algılanan gelir düzeyi ile UCLA-YÖ toplam puanı arasında istatiksel olarak anlamlı bir ilişki saptandı (p<0,001). Geliri giderinden az olan annelerin ortalamaları daha yüksekti. Gebe kalmayı isteme durumu ve bebek bakımında yardımcı olunma durumu (p=0,034) ile annelerin yalnızlık düzeyi arasında anlamlı ilişki olup (p=0,012) istemeyerek gebe kalan ve bebek bakımında yardımcı olunmayan anneler kendini daha yalnız hissediyordu. Katılımcıların C-19FÖ toplam puan ortalaması 46,94±13,49 (min:20, maks:79) idi. C-19FÖ toplam puanı ve tüm alt boyut puanları ile öğrenim durumu, meslek, algılanan gelir düzeyi, gebe kalmayı isteme durumu, bebek bakımında yardımcı olunma durumu arasında istatistiksel olarak anlamlı ilişki saptanmadı. C-19FÖ psikolojik alt boyut puanı ile doğum öncesi çalışma durumu arasında anlamlı ilişki saptandı (p=0,025), doğum öncesi çalışmayanlarda ortalama daha yüksekti. Katılımcıların COVID-19 geçirme durumuyla C-19FÖ somatik alt boyut (p=0,002), sosyal alt boyut (p=0,003), ekonomik alt boyut skorları (p=0,002) ve ölçeğin toplam skoru (p=0,001) arasında anlamlı ilişki saptandı. Katılımcıların EPDÖ toplam puanı ile UCLA-YÖ toplam puanı arasındaki korelasyon incelendiğinde pozitif yönde ve güçlü derecede istatistiksel olarak anlamlı bir korelasyon saptandı (r=0,615) (p<0,001). Katılımcıların EPDÖ toplam puanı ile C19-FÖ toplam puanı arasındaki korelasyonda pozitif yönde orta derecede anlamlı korelasyon saptandı (r=0,300) (p<0,001), UCLA-YÖ toplam puanı ile C-19FÖ toplam puanı arasındaki korelasyon incelendiğinde pozitif yönde zayıf derecede anlamlı bir korelasyon saptandı (r=0,150) (p=0,002).
Sonuç: Postpartum dönemdeki kadınlarda COVID-19 pandemisinin yol açtığı korku duygusunun ve doğumda, doğum sonrasında hastalığın bulaşma riskinden dolayı yakınlarından yeterince destek görememesinin sebep olduğu yalnızlık duygusunun postpartum depresyon
belirtilerini daha da arttırdığı sonucuna varılmıştır. Bizler birinci basamak hekimleri olarak gebelikte ve doğum sonrasında kontrole gelen anneleri postpartum depresyon açısından değerlendirilmeli ve hem anne hem bebek sağlığı için bu konuda erken önlemler almalı, gerekirse sevk etmeliyiz.
Aim: The reason for the feeling of fear caused by the COVID-19 pandemic in postpartum women who have gone through a very important and difficult period of their life who have just given birth and the risk of depression increases even when there are no extraordinary circumstances such as epidemic, and the lack of adequate support from any of their relatives due to the risk of transmission of the disease at birth and after delivery. It is thought that the feeling of loneliness in which they are alone may increase their depressive mood even more and cause them to have a more difficult time during this period. The aim of this study is to investigate the effect of COVID-19 phobia on depression and loneliness in postpartum women with a 4-8 weeks old baby admitted to primary care. Materials and methods: This study was carried out by including women who applied to 6 Family Health Centers selected from three central districts of Konya (Meram, Selçuklu, Karatay) between 01.06.2021 and 01.09.2021, 4-8 weeks after their birth. Sociodemographic information form to evaluate the sociodemographic characteristics of the participants and their characteristics related to their baby, the "Edinburgh Postpartum Depression Scale" to evaluate the postpartum depression status, the "COVID-19 Phobia Scale" to evaluate the COVID-19 phobia, and the "UCLA Loneliness Scale" for the loneliness levels were applied. SPSS 20.0 xii (Statistical Package for Social Sciences) program was used for statistical analysis. Statistical significance level was accepted as p<0.05. Results: The mean age of the 425 people participating in the study was calculated as 28.57±4.59 (min=18; max=42) years. 56.4% (n=240) of the participants were university graduates, 48.5% (n=206) were working before birth. The income of 21.9% (n=93) of the participants was more than their expenses, 55.3% (n=235) of them had income equal to their expenses, 22.8% of them had less than their expenses, 95.1% were living in the city center . The last pregnancy of 88.2% of the participants was a desired pregnancy and 22% of them did not receive any help in baby care. It was found that 22.3% of the participants (n=95) had symptoms of postpartum depression. There was a significant relationship between EPDS scores and educational status (p<0.001) and prenatal employment status (p<0.001). Those who did not work before had a higher mean. A statistically significant correlation was found between perceived income level and EPDS total score (p<0.001). The PPD frequency of the participants whose income was less than their expenses was higher than those whose income was equal to their expenses and whose income was more than their expenses. The frequency of PPD was higher in mothers who conceived unplanned (p=0.004) and had prenatal COVID-19 (p=0.001). A statistically significant relationship was found between the number of children (p=0.001), educational status (p<0.001) and prenatal employment status (p=0.004) and the level of loneliness of the participants. A statistically significant correlation was found between perceived income level and UCLA-YÖ total score (p<0.001). The mean of mothers whose income is less than their expenses were higher. There was a significant relationship between the state of wanting to become pregnant and being helped in baby care (p=0.034) and the level of loneliness of the mothers (p=0.012), and mothers who became pregnant unintentionally and were not helped in baby care felt lonelier. The total mean score of C-19FE of the participants was 46.94±13.49 (min:20, max:79). There was no statistically significant xiii relationship between C-19FE total score and all sub-dimension scores, and educational status, occupation, perceived income level, desire to become pregnant, and assistance in baby care. A significant correlation was found between C-19FI psychological sub-dimension score and prenatal employment status (p=0.025), and it was higher in average in those who did not work before birth. A significant correlation was found between the COVID-19 status of the participants and the C-19PI somatic sub-dimension (p=0.002), social sub-dimension (p=0.003), economic sub-dimension scores (p=0.002) and the total score of the scale (p=0.001). When the correlation between the participants' total EPDS score and UCLA-YÖ total score was examined, a strong and statistically significant correlation was found (r=0.615) (p<0.001). There was a moderately significant positive correlation (r=0.300) (p<0.001) in the correlation between the participants' EPDS total score and C19-PI total score. correlation was determined (r=0.150) (p=0.002). Conclusion: It has been concluded that the feeling of fear caused by the COVID-19 pandemic in women in the postpartum period and the feeling of loneliness caused by the lack of support from their relatives at birth and postpartum due to the risk of transmission of the disease further increase the symptoms of postpartum depression. As primary care physicians, mothers who come for control during pregnancy and after delivery should be evaluated in terms of postpartum depression, and we should take early precautions for both mother and baby health, and refer them if necessary.
Aim: The reason for the feeling of fear caused by the COVID-19 pandemic in postpartum women who have gone through a very important and difficult period of their life who have just given birth and the risk of depression increases even when there are no extraordinary circumstances such as epidemic, and the lack of adequate support from any of their relatives due to the risk of transmission of the disease at birth and after delivery. It is thought that the feeling of loneliness in which they are alone may increase their depressive mood even more and cause them to have a more difficult time during this period. The aim of this study is to investigate the effect of COVID-19 phobia on depression and loneliness in postpartum women with a 4-8 weeks old baby admitted to primary care. Materials and methods: This study was carried out by including women who applied to 6 Family Health Centers selected from three central districts of Konya (Meram, Selçuklu, Karatay) between 01.06.2021 and 01.09.2021, 4-8 weeks after their birth. Sociodemographic information form to evaluate the sociodemographic characteristics of the participants and their characteristics related to their baby, the "Edinburgh Postpartum Depression Scale" to evaluate the postpartum depression status, the "COVID-19 Phobia Scale" to evaluate the COVID-19 phobia, and the "UCLA Loneliness Scale" for the loneliness levels were applied. SPSS 20.0 xii (Statistical Package for Social Sciences) program was used for statistical analysis. Statistical significance level was accepted as p<0.05. Results: The mean age of the 425 people participating in the study was calculated as 28.57±4.59 (min=18; max=42) years. 56.4% (n=240) of the participants were university graduates, 48.5% (n=206) were working before birth. The income of 21.9% (n=93) of the participants was more than their expenses, 55.3% (n=235) of them had income equal to their expenses, 22.8% of them had less than their expenses, 95.1% were living in the city center . The last pregnancy of 88.2% of the participants was a desired pregnancy and 22% of them did not receive any help in baby care. It was found that 22.3% of the participants (n=95) had symptoms of postpartum depression. There was a significant relationship between EPDS scores and educational status (p<0.001) and prenatal employment status (p<0.001). Those who did not work before had a higher mean. A statistically significant correlation was found between perceived income level and EPDS total score (p<0.001). The PPD frequency of the participants whose income was less than their expenses was higher than those whose income was equal to their expenses and whose income was more than their expenses. The frequency of PPD was higher in mothers who conceived unplanned (p=0.004) and had prenatal COVID-19 (p=0.001). A statistically significant relationship was found between the number of children (p=0.001), educational status (p<0.001) and prenatal employment status (p=0.004) and the level of loneliness of the participants. A statistically significant correlation was found between perceived income level and UCLA-YÖ total score (p<0.001). The mean of mothers whose income is less than their expenses were higher. There was a significant relationship between the state of wanting to become pregnant and being helped in baby care (p=0.034) and the level of loneliness of the mothers (p=0.012), and mothers who became pregnant unintentionally and were not helped in baby care felt lonelier. The total mean score of C-19FE of the participants was 46.94±13.49 (min:20, max:79). There was no statistically significant xiii relationship between C-19FE total score and all sub-dimension scores, and educational status, occupation, perceived income level, desire to become pregnant, and assistance in baby care. A significant correlation was found between C-19FI psychological sub-dimension score and prenatal employment status (p=0.025), and it was higher in average in those who did not work before birth. A significant correlation was found between the COVID-19 status of the participants and the C-19PI somatic sub-dimension (p=0.002), social sub-dimension (p=0.003), economic sub-dimension scores (p=0.002) and the total score of the scale (p=0.001). When the correlation between the participants' total EPDS score and UCLA-YÖ total score was examined, a strong and statistically significant correlation was found (r=0.615) (p<0.001). There was a moderately significant positive correlation (r=0.300) (p<0.001) in the correlation between the participants' EPDS total score and C19-PI total score. correlation was determined (r=0.150) (p=0.002). Conclusion: It has been concluded that the feeling of fear caused by the COVID-19 pandemic in women in the postpartum period and the feeling of loneliness caused by the lack of support from their relatives at birth and postpartum due to the risk of transmission of the disease further increase the symptoms of postpartum depression. As primary care physicians, mothers who come for control during pregnancy and after delivery should be evaluated in terms of postpartum depression, and we should take early precautions for both mother and baby health, and refer them if necessary.
Açıklama
Anahtar Kelimeler
Postpartum depresyon, COVID-19 pandemisi, Sosyal yalnızlık, Postpartum depression, COVID-19 pandemic, Social loneliness
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Özsöz, İ. E. (2023). Postpartum dönemde COVİD-19 fobisinin yalnızlık ve depresyon üzerine etkisinin incelenmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahilİ Tıp Bilimleri Bölümü Aile Hekimliği Anabilim Dalı, Konya.
